Improving Osteoporosis Screening Rates in a Rural Primary Care Clinic

Background and Objectives: Osteoporosis related fracture rates are high yet lack of screening and education on osteoporosis remains a significant problem. The United States Preventative Services Task Force (USPSTF) recommends bone mineral density testing in women ≥ 65 and in women aged 50-64, based on specific risk factors. Using a screening tool such as the simple calculated osteoporosis risk tool (SCORE) is beneficial in identifying individuals that should be referred for BMD testing. Screening for BMD using dual-energy absorptiometry (DXA) is the gold standard in predicting major fractures, allowing for timely intervention in the primary care setting. Consequently, a plan was developed using these tools to increase osteoporosis screening rates. Methods: The quality improvement project was implemented using the Donabedian model for quality care at a rural primary care clinic in the Midwestern United States. Participants included office staff and eligible patients (women ≥ 50 years of age). A process was developed to screen individuals for osteoporosis using the SCORE tool in the electronic health record (EHR). A screening score of ≥ 6 indicated the need to refer for DXA. The QI project measures included: total number of patients screened, quantity of DXA referrals, completed DXA scans, and a pre/post-implementation staff survey. Results: There was a statistically significant increase in the number of patients screened for osteoporosis risk in comparison to the pre-implementation period. Conclusions: The process for osteoporosis screening improved screening rates

An exploratory evaluation of the Ward and Hudson Offending Pathways model with sex offenders who have intellectual disability

Background It was predicted that offenders with intellectual disability ( ID) categorised according to Ward & Hudson's ( 1998b) self- regulation theory as having an Approach goal would have higher levels of distorted cognitions, less victim empathy, and a history of more prolific offending compared to those with an Avoidant goal. Offenders categorised as having a Passive strategy were hypothesised to have lower levels of general intellectual functioning, and more known offences and convictions compared to those with an Active strategy. Method Using a cross- sectional independent groups design, the offence pathways of 34 men with ID who were taking part in group cognitive behavioural therapy were rated by therapists. Participants assigned to each pathway were then compared using measures of sexual knowledge, distorted cognitions, and victim empathy. Cronbach's alpha for the measures was found to be acceptable. Results Offenders with an Approach goal were found to have higher levels of distorted cognitions and more denial about the negative impact of their offending upon their victims on one measure of distorted cognitions, while on another measure of distorted cognitions there were no differences. There were no differences between Approach and Avoidant offenders in terms of victim empathy, socio- sexual knowledge, severity of offending, and victim type. Offenders with a Passive strategy were found to have lower levels of general intellectual functioning than offenders with an Active strategy, but did not have more known offences and convictions. Conclusions The findings provide partial support for the usefulness of the Offending Pathways model in understanding the sexual offence processes of men with ID. The difficulties with this study are further discussed, together with the theoretical implication

Building

Lost in the Stacks Bonus Podcast A.Lost in the Stacks bonus podcast A, titled "Building". Hosted by Ameet Doshi and Charlie Bennett. Includes interviews with Georgia Tech Professor Hugh Crawford and his students on location of the Thoreau house frame-raising in front of the GT Architecture Building, and with Cathy Carpenter, head of Tech's Architecture Library